<form id="score-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">当前陪诊师:</label>
        <div class="col-xs-12 col-sm-8" style="line-height: 37px;">
            {$order.escort.realname}
        </div>
    </div>
    <input type="hidden" id="city_id" value="{$order.city_id}">
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2"><b class="text-danger">*</b>修改陪诊师:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-escort_id" data-rule="required" data-source="carers/index" data-params='{"custom[level]":"1"}' data-field="realname" class="form-control selectpage" name="row[escort_id]" type="text" value="">
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-primary btn-embossed ">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>